Iro H, Zenk J, Waldfahrer F, Benzel W
Klinik und Poliklinik für Hals-Nasen-Ohrenkrankheiten, Universität Erlangen-Nürnberg.
HNO. 1996 Feb;44(2):78-84.
Newly available minimally invasive methods have changed established treatment of human sialolithiasis during the past several years. After basic in vitro and in vivo investigations, two systems of shockwave treatment proved to be useful for clinical application: extracorporeal shockwave lithotripsy (piezoelectric system) and intracorporeal laser lithotripsy (using a rhodamine-6G dye laser). Following our clinical experiences with these methods a differential scheme for managing sialolithiasis is recommended depending on localization of the calculi and their maximal diameters. Submandibular stones are best treated by extra-corporeal lithotripsy if the stone is located in intraglandular parts or in the gland hilum. Stones of the hilum can also be treated by laser lithotripsy. In the distal parts and near the duct orifice, papillotomy and stone extraction should be tried independent of the stone size. If the stone is located in the intraglandular parts of the duct system or in the hilum and its diameter is over 12 mm, submandibulectomy is necessary. Calculi of the parotid gland should only be treated by extracorporeal lithotripsy, regardless of size and location.
在过去几年中，新出现的微创方法改变了人类涎石病的既定治疗方式。经过基础的体外和体内研究，两种冲击波治疗系统被证明可用于临床应用：体外冲击波碎石术（压电系统）和体内激光碎石术（使用罗丹明 - 6G染料激光）。根据我们对这些方法的临床经验，建议根据结石的位置及其最大直径制定涎石病的差异化治疗方案。如果结石位于颌下腺腺体内或腺门处，下颌下腺结石最好通过体外碎石术治疗。腺门处的结石也可通过激光碎石术治疗。在导管远端和靠近导管口处，无论结石大小，都应尝试进行乳头切开术和结石取出术。如果结石位于导管系统的腺体内或腺门处，且直径超过12毫米，则需要进行下颌下腺切除术。腮腺结石无论大小和位置如何，都应仅通过体外碎石术治疗。
